DERR-2024-004689

FORM 1
SUMMARY OF SOURCE TEST DATA
SOURCE INFORMATION FACILITY PARAMETERS
GDF Name and addresss GDF Representative and Title
_________________________________
PHASE II SYSTEM TYPE
(Check One)
Balance ____
Hirt ____
Red Jacket ____
Hasstech ____ Healy ____Other
GDF Phone No. (___)________________
Permit Conditions Source: GDF Vapor Recovery System
GDF #
A/C # Manifolded? Y or N
Operating Parameters
Number of Nozzles Served by Tank #1 ______ Number of Nozzles Served by Tank #3 ______
Number of Nozzles Served by Tank #2 ______ Number of Nozzles Served by Tank #4 ______
Applicable Regulations: VN Recommended
Source Test Results and Comments
Tank #:
1.Product Grade
2.Actual Tank Capacity, gallons
3.Gasoline Volume
4.Ullage, gallons (#2-#3)
5.Initial Pressure, inches H 2 O
6.Pressure After 1 Minute, inches H 2 O
7.Pressure After 2 Minutes, inches H 2 O
8.Pressure After 3 Minutes, inches H 2 O
9.Pressure After 4 Minutes, inches H 2 O
10.Final Pressure After 5 Minutes, inches H 2 O
11.Allowable Final Pressure
Test Conducted by: Test Company: Date of Test:
California Air Resources Board July 26, 2012
TP-201.3, Page 14
40CFR63CCCCCC
Precision Testing Technologies
Smith's #276
5486 W Daybreak
Pkwy, West Jordon,ut
1
Reg
19782
15959
3823
2
1.97
1.95
1.92
1.89
1.86
1.65
2
Prm
7901
5919
1982
2
1.93
1.89
1.84
1.80
1.77
1.37
Garrett Herlache UT-411 08/10/2022
Pressure/Vacuum (P/V) Vent Valve Data Sheet
Facility Name: Test Date:
Address: Test Company: Precision Testing Technologies
City: Tester Name:
Product:
P/V Valve Manufacturer: Model Number: Pass Fail
Manufacturers Specified
Positive Leak Rate (CFH):
Manufacturers Specified
Negative Leak Rate (CFH):
Measured Positive Leak Rate (CFH): Measured Negative Leak Rate (CFH):
Positive Cracking Pressure (in H2O): Negative Cracking Pressure (in H2O):
Product:
P/V Valve Manufacturer: Model Number: Pass Fail
Manufacturers Specified
Positive Leak Rate (CFH):
Manufacturers Specified
Negative Leak Rate (CFH):
Measured Positive Leak Rate (CFH): Measured Negative Leak Rate (CFH):
Positive Cracking Pressure (in H2O): Negative Cracking Pressure (in H2O):
Product:
P/V Valve Manufacturer: Model Number: Pass Fail
Manufacturers Specified
Positive Leak Rate (CFH):
Manufacturers Specified
Negative Leak Rate (CFH):
Measured Positive Leak Rate (CFH): Measured Negative Leak Rate (CFH):
Positive Cracking Pressure (in H2O): Negative Cracking Pressure (in H2O):
Product:
P/V Valve Manufacturer: Model Number: Pass Fail
Manufacturers Specified
Positive Leak Rate (CFH):
Manufacturers Specified
Negative Leak Rate (CFH):
Measured Positive Leak Rate (CFH): Measured Negative Leak Rate (CFH):
Positive Cracking Pressure (in H2O): Negative Cracking Pressure (in H2O):
2.5" to 6" wc
<=0.05 cfh @ 2" wc
6" to 10" wc
<=0.21 cfh @ 4" wc
2.5" to 6" wc
<=0.05 cfh @ 2" wc
2.5" to 6" wc
<=0.05 cfh @ 2" wc
6" to 10" wc
<=0.21 cfh @ 4" wc
6" to 10" wc
<=0.21 cfh @ 4" wc
6" to 10" wc
<=0.21 cfh @ 4" wc
2.5" to 6" wc
<=0.05 cfh @ 2" wc
Smith's #276
5486 W Daybreak Pkwy
West Jordan, UT 84009
08/10/2022
Garrett Herlache UT-411
Reg
OPW 623V 4
0.02
3.20
0.14
-7.72
Prm
OPW 623V 4
0.02
3.02
0.10
-7.91
California Air Resources Board October 8, 2003
TP-201.1B, Page 5
Form 1
Static Torque of Rotatable Phase I Adaptors
Measurement Units: (Check Box): pound-inches pound-feet
Vapor Adaptor 1 Vapor Adaptor 2 Vapor Adaptor 3 Vapor Adaptor 4
Brand:Brand:Brand:Brand:
Model:Model:Model:Model:
Grade:Grade:Grade:Grade:
Torque 1:Torque 1:Torque 1:Torque 1:
Torque 2:Torque 2:Torque 2:Torque 2:
Torque 3:Torque 3:Torque 3:Torque 3:
Average:Average:Average:Average:
360 Rotation:360 Rotation: 360 Rotation:360 Rotation:
Product Adaptor 1 Product Adaptor 2 Product Adaptor 3 Product Adaptor 4
Brand:Brand:Brand:Brand:
Model:Model:Model:Model:
Grade:Grade:Grade:Grade:
Torque 1:Torque 1:Torque 1:Torque 1:
Torque 2:Torque 2:Torque 2:Torque 2:
Torque 3:Torque 3:Torque 3:Torque 3:
Average:Average:Average:Average:
360 Rotation: 360 Rotation: 360 Rotation:360 Rotation:
Comments: ___________________________________________________________________
Test Company:Conducted By:
Test Date:Facility Name:
Facility Address:City:
Precision Testing Technologies Garrett Herlache UT-411
08/10/2022 Smith's #276
5486 W Daybreak Pkwy West Jordan, UT 84009
4
OPW
61VSA
Reg
95
90
90
91.66
Yes
OPW
61SALP
Reg
90
95
95
93.33
Yes
OPW
61VSA
Prm
60
60
60
60
Yes
Prm
61SALP
PRM
90
90
90
90
Yes
Yes
Yes
Yes
Yes